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Bundle Branch Block

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https://www.readbyqxmd.com/read/28820653/fibrous-skeleton-of-the-heart-anatomic-overview-and-evaluation-of-pathologic-conditions-with-ct-and-mr-imaging
#1
Farhood Saremi, Damián Sánchez-Quintana, Shumpei Mori, Horia Muresian, Diane E Spicer, Cameron Hassani, Robert H Anderson
The fibrous skeleton is concentrated at the base of the ventricular mass. It provides electrical insulation at the atrioventricular level and fibrous continuity for the leaflets of the mitral, aortic, and tricuspid valves. Its components include the fibrous trigones, the fibrous area of aortic-mitral continuity, the subvalvar collar of the mitral valve, the membranous septum, the interleaflet triangles, the tendon of Todaro, and likely the conus ligament. The majority of the mitral annulus is fibrous, but the only true fibrous part of the tricuspid annulus is where the valvar leaflets are attached to the central fibrous body...
August 18, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28800177/exercise-stress-test-reveals-ineligibility-for-subcutaneous-implantable-cardioverter-defibrillator-in-patients-with-brugada-syndrome
#2
Motomi Tachibana, Nobuhiro Nishii, Hiroshi Morita, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Ito
BACKGROUND: The eligibility of patients with Brugada syndrome (BrS) for implantation of a subcutaneous implantable cardioverter defibrillator (S-ICD) is not well known. This study aimed to clarify the eligibility of BrS patients for S-ICD using electrocardiography (ECG) at rest and during exercise testing. We also analyzed factors associated with ineligibility for S-ICD from standard 12-lead ECG at rest. METHODS: We enrolled 110 consecutive BrS patients who visited Okayama university hospital from December 2015 to December 2016...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28794532/local-anaesthetic-systemic-toxicity-following-oral-ingestion-in-a-child-revisiting-dibucaine
#3
Raylene Dias, Nandini Dave, Milind S Tullu, Chandrahas T Deshmukh
Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations. Systemic toxicity following oral ingestion of local anaesthetics is rare. We report a case of accidental ingestion of dibucaine (ear drops) in a 7-year-old child who developed diplopia, giddiness, ventricular premature contractions and a right bundle branch block. We also present a brief discussion on the pharmacologic and toxicity profile of dibucaine, the Naranjo algorithm for assessing causality in case of adverse drug reactions and a review of current guidelines on the management of local anaesthetic systemic toxicity...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28794367/earlier-right-ventricular-pacing-in-cardiac-resynchronization-therapy-for-a-patient-with-right-axis-deviation
#4
Yusuke Hattori, Kohei Ishibashi, Takashi Noda, Hideo Okamura, Hideaki Kanzaki, Toshihisa Anzai, Satoshi Yasuda, Kengo Kusano
We describe the case of a 37-year-old woman who presented with complete right bundle branch block and right axis deviation. She was admitted to our hospital due to severe heart failure and was dependent on inotropic agents. Cardiac resynchronization therapy was initiated but did not improve her condition. After the optimization of the pacing timing, we performed earlier right ventricular pacing, which led to an improvement of her heart failure. Earlier right ventricular pacing should be considered in patients with complete right bundle branch block and right axis deviation when cardiac resynchronization therapy is not effective...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28794085/idiopathic-ventricular-arrhythmias-originating-from-the-parietal-band-electrocardiographic-and-electrophysiological-characteristics-and-outcome-of-catheter-ablation
#5
Takumi Yamada, Naoki Yoshida, Taihei Itoh, Silvio H Litovsky, Harish Doppalapudi, H Thomas McElderry, G Neal Kay
BACKGROUNDS: The parietal band is one of the muscle bands in the right ventricle. This study investigated the electrocardiographic and electrophysiological characteristics and ablation outcome of idiopathic ventricular arrhythmias (VAs) originating from the parietal band. METHODS AND RESULTS: We studied 14 patients with idiopathic VA origins in the parietal band among 294 consecutive patients with VA origins in the right ventricle. The QRS morphologies of the parietal band VAs were characterized by a left bundle branch block and left inferior (n=12) or superior (n=2) axis pattern with the presence of a notch in the middle of the QRS in all cases, precordial transition at ≤lead V3 in 7 patients, and a slow QRS onset in 4 patients...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28791747/ecg-morphology-of-premature-ventricular-contractions-predicts-presence-of-myocardial-fibrotic-substrate-on-cardiac-magnetic-resonance-imaging-in-patients-undergoing-ablation
#6
Sabrina Oebel, Borislav Dinov, Arash Arya, Sebastian Hilbert, Philipp Sommer, Andreas Bollmann, Gerhard Hindricks, Ingo Paetsch, Cosima Jahnke
BACKGROUND: The most likely origin of PVCs may be deduced from surface ECG analysis while planning an electrophysiological study (EPS). Apart from purely benign forms of increased ventricular ectopy, myocardial substrate (e.g., regional fibrosis) may be present in certain cases, which will significantly impact the ablation approach. CMR imaging can reliably identify fibrotic target lesions and, hence, may assist in adequate patient selection and procedural planning. METHODS AND RESULTS: We analyzed 101 patients (59% male, mean age 57...
August 9, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28781860/masquerading-bundle-branch-block-obscuring-the-diagnosis-of-brugada-syndrome-an-electrocardiographic-and-vectorcardiographic-study
#7
Isabel V Konopka, Hugo A Garro, Rita B Tepper, Norma Pizzarelli, Mario D Gonzalez, Rafael S Acunzo
We describe the induction of a masquerading bundle branch block in two patients with Brugada syndrome following the administration of Ajmaline. The development of this conduction disturbance prevented the correct electrocardiographic diagnosis. However, the simultaneously obtained vectocardiogram identified both the Brugada pattern and the masquerading bundle branch block.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28781300/successful-catheter-ablation-as-a-substitute-for-cardiac-resynchronization-therapy-in-patient-with-an-accessory-pathway-induced-cardiomyopathy
#8
Keisuke Nakabayashi, Ryo Sugiura, Yusuke Mizuno, Hiroko Kato, Naomi Nakazawa, Toshiaki Suzuki, Hideki Saito, Naomi Kawakatsu, Masayuki Goto, Daichi Isomura, Hisayuki Okada, Toshiaki Oka
A 50-year-old man presented with exertional dyspnea and orthopnea. An electrocardiogram showed a delta wave and a wide QRS complex, similar to left bundle branch block. Cardiac echocardiography revealed diffuse severe hypokinesis and dyssynchrony. The patient was diagnosed with congestive heart failure. We considered that the patient's condition was caused by an accessory pathway-induced cardiomyopathy after heart failure compensation with guideline-oriented medical therapy. We therefore performed catheter ablation for right-sided pre-excitation syndrome as cardiac resynchronization therapy...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28772031/local-microrna-133a-downregulation-is-associated-with-hypertrophy-in-the-dyssynchronous-heart
#9
Lars B van Middendorp, Marion Kuiper, Chantal Munts, Philippe Wouters, Jos G Maessen, Frans A van Nieuwenhoven, Frits W Prinzen
AIMS: Left bundle branch block (LBBB) creates considerable regional differences in mechanical load within the left ventricle (LV). We investigated expression of selected microRNAs (miRs) in relation to regional hypertrophy and fibrosis in LBBB hearts and their reversibility upon cardiac resynchronization therapy (CRT). METHODS AND RESULTS: Eighteen dogs were followed for 4 months after induction of LBBB, 10 of which received CRT after 2 months. Five additional dogs served as control...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28765745/rapid-and-potent-antiarrhythmic-effect-of-cardiac-resynchronization-therapy-in-a-patient-with-advanced-dilated-cardiomyopathy-and-a-large-ventricular-arrhythmia-burden
#10
Dong Sub Jeon, Jong Sung Park
We report a case demonstrating a rapid and potent antiarrhythmic effect of biventricular pacing. A 67-year-old male patient with dilated cardiomyopathy was admitted for heart failure. The initial surface electrocardiogram revealed a left bundle branch block with a QRS complex duration of 200 ms. Echocardiographic examination revealed a left ventricular ejection fraction of 16%, a left ventricular end-diastolic dimension of 91 mm, and marked interventricular dyssynchrony. Continuous rhythm monitoring revealed frequently-recurring non-sustained monomorphic ventricular tachycardia (VT)...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28762918/-noninvasive-electrophysiological-mapping-in-patients-with-complete-left-bundle-branch-block-and-different-modes-of-biventricular-pacing
#11
S V Zubarev, M P Chmelevsky, M A Budanova, M A Trukshina, T A Lyubimtseva, V K Lebedeva, D S Lebedev
OBJECTIVE: to investigate possibilities of noninvasive electrophysiological mapping (NEM) during biventricular (BiV) pacing and to compare the results with data of 12 lead ECG and tissue Doppler echocardiography (TDI). MATERIAL AND METHODS: The study included 25 patients with complete left bundle branch block (LBBB) and implanted cardiac resynchronization therapy (CRT) system. Twenty-two patients were CRT responders, three other patients did not demonstrate a clear effect...
May 2017: Kardiologiia
https://www.readbyqxmd.com/read/28759818/histological-topography-of-the-atrioventricular-node-and-its-extensions-in-relation-to-the-cardiothoracic-surgical-landmarks-in-normal-human-hearts
#12
Arpandeep Randhawa, Tulika Gupta, Anjali Aggarwal, Daisy Sahni, Rana Sandip Singh
BACKGROUND: Atrioventricular (AV) nodal injury which results in cardiac conduction disorders is one of the potential complications of heart valve surgeries and radiofrequency catheter ablations. Understanding the topography of the AV conduction system in relation to the tricuspid and mitral valves will help in reducing these complications. METHODS: A tissue block of 3cmx4cm, which contain the AV node, bundle of His and the AV nodal extensions, was excised at the AV septal junction in 20 apparently normal human hearts...
June 30, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28757765/pulseless-electrical-activity-in-acute-massive-pulmonary-embolism-during-thrombolytic-therapy
#13
Han-Hua Yu, Jing-Ren Jeng
We report a case of acute pulmonary embolism with hemodynamic instability diagnosed by a computed tomography pulmonary angiogram. The patient developed pulseless electrical activity during systemic thrombolytic therapy with recombinant tissue plasminogen activator. Successful return of spontaneous circulation was achieved after immediate cardiopulmonary resuscitation with chest compressions for 6 min. His electrocardiogram (ECG) on arrival in the emergency department displayed sinus tachycardia, an S wave in lead I, a Q wave in lead III, incomplete right bundle branch block (RBBB), T-wave inversion (TWI) in leads V1-V3, ST elevation in leads aVR and V1, and ST depression in leads I, II, III, aVF, and V4-V6...
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28756427/thrombolysis-a-useful-tool-in-the-primary-pci-cupboard
#14
Konstantin Schwarz, Deepak Goyal, Helen Routledge
A 44-year-old woman presented to the emergency department with central crushing chest pain and dynamic anterior ST elevation on a background of a known left bundle-branch block on her electrocardiogram. Past medical history included insulin-dependent diabetes, asthma, fibromyalgia, and a gradually failing kidney transplant. This case demonstrates the rarely utilized niche role for intracoronary thrombolysis in STEMI treatment in the modern angioplasty era.
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28736019/endomyocardial-biopsy-via-the-femoral-vein-using-a-long-curved-sheath
#15
N Naderi, S Taghavi, A Amin, G Houshmand, K Mozaffari, M Maleki
BACKGROUND: Endomyocardial biopsy (EMB) has been defined as the gold standard method for surveillance of rejection after heart transplantation, and it has also been used in the diagnosis of myocarditis and the unknown causes of cardiomyopathies. The procedure, however, is not free from complications. Access through the jugular vein or the femoral vein is the standard approach. In this study, we performed biopsies by using a long, curved sheath and evaluated the rate of complications with this technique...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28734886/pre-transcatheter-aortic-valve-replacement-right-bundle-branch-block-a-bundle-of-trouble
#16
EDITORIAL
Ron Waksman, Arie Steinvil
No abstract text is available yet for this article.
July 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28734885/clinical-impact-of-baseline-right-bundle-branch-block-in-patients-undergoing-transcatheter-aortic-valve-replacement
#17
Vincent Auffret, John G Webb, Hélène Eltchaninoff, Antonio J Muñoz-García, Dominique Himbert, Corrado Tamburino, Luis Nombela-Franco, Fabian Nietlispach, César Morís, Marc Ruel, Antonio E Dager, Vicenç Serra, Asim N Cheema, Ignacio J Amat-Santos, Fábio Sandoli de Brito, Pedro Alves Lemos, Alexandre Abizaid, Rogério Sarmento-Leite, Eric Dumont, Marco Barbanti, Eric Durand, Juan H Alonso Briales, Alec Vahanian, Claire Bouleti, Sebastiano Immè, Francesco Maisano, Raquel Del Valle, Luis Miguel Benitez, Bruno García Del Blanco, Rishi Puri, François Philippon, Marina Urena, Josep Rodés-Cabau
OBJECTIVES: This study sought to assess the influence of baseline right bundle branch block (RBBB) on all-cause and cardiovascular mortality as well as sudden cardiac death (SCD) among patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Few data exist regarding the late clinical impact of pre-existing RBBB in TAVR recipients. METHODS: A total of 3,527 patients (mean age 82 ± 8 years, 50.1% men) were evaluated according to the presence of RBBB on baseline electrocardiography...
July 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28730895/incidence-treatment-strategies-and-outcomes-of-acute-coronary-syndrome-with-and-without-ongoing-myocardial-ischaemia-results-from-the-czech-3-registry
#18
Petr Tousek, Klara Staskova, Anna Mala, Martin Sluka, Alexandra Vodzinska, Radek Jancar, Denisa Maluskova, Jiri Jarkovsky, Petr Widimsky
BACKGROUND: Patients with acute coronary syndrome with signs of ongoing myocardial ischaemia at first medical contact should be indicated for immediate invasive treatment. AIM: To assess the incidence, treatment strategies and outcomes of acute coronary syndrome in a large unselected cohort of patients with respect to the signs of ongoing myocardial ischaemia. METHODS: The CZECH-3 registry included 1754 consecutive patients admitted for suspected acute coronary syndrome to 43 hospitals during a 2-month period in the autumn of 2015...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28724945/effect-of-septal-flash-on-right-ventricular-systolic-function-in-left-bundle-branch-block-patients-with-preserved-left-ventricular-ejection-fraction
#19
Guang-Yuan Li, Yong-Huai Wang, Zheng-Yu Guan, Xuan-Yi Jin, Yang Li, Shuang Liu, Chun-Yan Ma, Jun Yang
A leftward motion of the ventricular septum prior to ejection, known as the septal flash (SF), is frequently observed in patients with left bundle-branch block (LBBB). We investigated whether the abnormal motion of the ventricular septum affects right ventricle (RV) contractile performance in LBBB patients with preserved left ventricular ejection fraction (LVEF). Forty-four patients with complete LBBB were selected using standard 12-lead electrocardiograms (ECGs), with 30 healthy individuals serving as controls...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28712585/conduction-disturbance-after-isolated-surgical-aortic-valve-replacement-in-degenerative-aortic-stenosis
#20
You Mi Hwang, Jun Kim, Ji Hyun Lee, Minsu Kim, Jongmin Hwang, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Gi Byoung Nam, Kee Joon Choi, Cheol Hyun Chung, Jae Won Lee, You Ho Kim
OBJECTIVE: Conduction disturbances are common in patients with aortic stenosis. We investigated the incidence, reversibility, and prognosis of conduction disorders requiring permanent pacemaker implantation in patients with degenerative aortic stenosis after isolated aortic valve replacement. METHODS: This was a retrospective study conducted at a tertiary care center. We evaluated the incidence of conduction disturbances in patients who underwent isolated surgical aortic valve replacement for aortic stenosis between January 2005 and May 2015...
June 15, 2017: Journal of Thoracic and Cardiovascular Surgery
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